Foreshortening

Quick reference:↑ LV size, geometry and mass ↑ LV systolic function, wall motion and strain

View	Apical four- and two-chamber views at reduced depth focused on the LV cavity; dedicated atrial views separately.
Timing	Check alignment before tracing end-diastolic and end-systolic frames.
Caliper / trace	LV traced along the compacted/noncompacted interface, papillary muscles and trabeculae in the cavity; LV lengths in the two views within 10%.

Example

Schematic comparison of an ellipsoid LV with a tapering apex and a shortened LV with a rounded apex. — True long axis versus foreshortened cavity. (Schematic drawing (E/e′ureka), not a patient image)

Correct example

Apex at the top centre of the sector, the ventricle tapering to an ellipsoid, and roughly two-thirds LV to one-third LA along the long axis; the transducer is moved laterally or down an interspace until the true apex is seen.

Common error

Accepting a view in which the apex looks rounded and the cavity short; the long axis is cut obliquely and the apex in the image is not the anatomical apex.

Effect on interpretation

Foreshortening underestimates LV volumes and erroneously increases apical segmental strain; it can also hide apical pathology. 3D acquisitions are largely unaffected.

Why

The method of disks assumes the traced contour spans the full long axis; a plane that misses the apex produces a shorter, rounder contour whose summed disks underestimate the true volume.